Florida Man Charged in Healthcare Fraud, Wire Fraud, and Conspiracy to Violate the Anti-Kickback Statute

A 28-year-old Florida man is facing numerous charges related to a scheme to defraud Medicare by billing for medically unnecessary prescriptions. Federal authorities announced charges in an 8-count indictment alleging conspiracy to commit healthcare fraud, conspiracy to commit wire fraud, healthcare fraud, conspiracy to violate the federal anti-kickback statute, and payment of illegal kickbacks.

According to the indictment, the defendant operated Hype Med, LLC, which generated medically unnecessary prescriptions through a telemedicine and telemarketing scheme. To execute the healthcare fraud and wire fraud conspiracy, the defendant identified Medicare recipients and targeted them for expensive drugs. Call center employees would contact the beneficiaries by phone to pressure them to agree to try expensive medications such as pain creams, scar creams, migraine medication, as well as a combination of medications intended to be used as a “foot soak”.

The defendant, through his company, then transmitted recordings of the telephone calls together with pre-marked prescription pads for the expensive drugs that would yield exorbitant reimbursements to the telemedicine companies. The defendant’s company then paid the telemedicine companies kickbacks for every beneficiary referred for a prescription. The telemedicine company, in turn, paid doctors to approve the prescriptions. The defendant then directed the prescriptions to pharmacies with whom the defendant had a kickback agreement. The pharmacies filled the prescriptions and then sought reimbursement from insurers including Medicare. The pharmacies would then pay a portion of the reimbursement back to the defendant’s company. The defendant received over $300,000 in illegal kickbacks using this scheme. Individuals associated with the pharmacy are charged in a separate indictment.

Tallying up the charges 

This defendant is charged with numerous counts related to the scheme. He faces a maximum 20 years in prison on the conspiracy to commit healthcare fraud charges, a maximum 20 years in prison on the wire fraud charges, 10 years in prison on the healthcare fraud charges, 5 years in prison for violating the Anti-Kickback Statute, and 10 years in prison for payment of illegal kickbacks. These counts are also punishable by a fine of up to $250,000 or twice the gain the defendant received from the offense, whichever is greater.

Healthcare fraud charges 

Healthcare fraud charges are a growing problem for the federal government. In this case, the defendant was charged with conspiring with several other actors to pressure patients into getting prescriptions for expensive medications. Each party paid the other for a cut of the reimbursements distributed by private insurance companies and Medicare. The prescriptions were considered medically unnecessary. The process by which the defendant used telemarketing companies to pressure patients into these prescriptions was also illegal.

Talk to a Tampa, FL Federal Charges Defense Lawyer Today 

The Matassini Law Firm represents the interests of those facing federal charges for crimes such as fraud. Such crimes are generally charged by the federal government and often come with mandatory minimum sentences. Call our Tampa criminal lawyers today to schedule an appointment, and we can help you get out ahead of the charges right away. Nicholas G. Matassini is Board Certified in Criminal Trial Law by The Florida Bar, the highest recognition of professionalism and trial experience in Florida.

Source:

justice.gov/usao-nj/pr/florida-man-charged-health-care-fraud-wire-fraud-and-kickback-conspiracy#:~:text=The%20health%20care%20fraud%20and,penalty%20of%20five%20years%20in